Amniotic fluid embolism occurs when amniotic fluid and its components—such as meconium, mucin, lanugo, squamous epithelium, and vernix—enter the maternal bloodstream through damaged cervical arteries, blood sinuses at the placental attachment site, or uterine lacerations. These substances form emboli in vital organs like the lungs and heart, causing severe symptoms including respiratory distress, chills, cyanosis,chest pain, shock, hemorrhage, and other severe symptoms.
Causes of amniotic fluid embolism: Multiple pregnancies, excessive or frequent uterine contractions, meconium-stained amniotic fluid, or procedures like normal delivery, mid-term induced abortion, late-term abortion, and cesarean section can all potentially force amniotic fluid into the maternal bloodstream.
Preventive Measures: Amniotic fluid embolism is more likely to occur in cases of rapid labor, placenta previa, placental abruption, uterine rupture, and cesarean sections. To effectively prevent amniotic fluid embolism, regular prenatal checkups are essential—a crucial component of maternal healthcare.In cases of placenta previa, premature rupture of membranes, or placental abruption, the mother must remain in the hospital for delivery. Medical professionals will closely monitor changes in both the mother and fetus, enabling timely intervention and critical emergency response time should complications arise.
III. Premature Rupture of Membranes (PROM)
PROM is a highly critical condition that can readily lead to infection, jeopardizing the health and safety of both mother and baby.
Causes of Premature Rupture of Membranes:
1. Cervical incompetence (weakened cervix).
2. Abnormal development of the fetal membranes.
3. Malpresentation, narrow pelvis, cephalopelvic disproportion, polyhydramnios, or multiple pregnancies.
4. Amniochorionic infection due to careless sexual activity during pregnancy.
5. Severe coughing, sudden laughter or intense anger, and heavy physical labor during pregnancy.
Risks of Premature Rupture of Membranes: 1. Inducing preterm labor. 2. Causing fetal distress. 3. Leading to prolonged labor and fetal hypoxia. 4. Resulting in maternal-fetal infection.
How to distinguish preterm rupture of membranes: When uncertain whether fluid leakage is amniotic fluid or urine, insert a specific chemical test strip into the vagina. If amniotic fluid is present, it will turn the orange-yellow strip dark green. Bring the strip to the hospital for microscopic examination; the presence of small fat globules and lanugo (fetal hair) in the fluid confirms preterm rupture.
Four Wise Measures to Prevent Premature Rupture of Membranes:
1. Maintain regular prenatal checkups: Monthly visits from 4-6 months; biweekly visits from 7-9 months; weekly visits after 9 months. Seek immediate examination for any unusual symptoms.
2. Avoid strenuous activities during mid-to-late pregnancy. Maintain a balanced lifestyle without excessive fatigue. Keep a positive mindset daily and take moderate walks outdoors.
3. Refrain from long walks or running. Walk carefully to prevent falls, especially when navigating stairs. Avoid lifting heavy objects and prolonged travel on bumpy roads.
4. Reduce sexual activity during pregnancy, especially during the last three months. Abstain completely during the final month to avoid uterine stimulation that could cause premature rupture of membranes (PROM).
Emergency Response for Premature Rupture of Membranes:
1. Remain calm if PROM occurs. Immediately have the mother lie down with her hips elevated to prevent umbilical cord prolapse.
2. Place a clean sanitary pad over the vulva and maintain genital hygiene.
3. Seek immediate medical attention at a hospital upon any rupture of membranes. Maintain the elevated-hip position throughout the journey to the hospital.